Spondylolysis at L5

Bigger Stronger Leaner Injuries and Rehab
1

Hey guys.
Backstory: I’m a competitive olympic weightlifter, and while coming out of the whole on a clean four days ago my back gave out, in the direction of extension. From a third person perspective, it was almost like I hyperextended an additional 10-15 degrees (I already have an abnormally flexible lordosis, something like 2x the norm. I’m finishing up Physical Therapy school and had it measured in lab once). Needless to say, it may have been the most frightening experience I’ve ever had. I immediately dumped the weight, sat down in a fully flexed position, didn’t notice any neuro s/sx, loss of muscle function, etc. Went home, showered, popped ibuprofen, and debated all night to swing into the emergency room (slept supine, legs elevated with pillows).

Got an x-ray done and was initially told no spondylolisthesis, no fractures, just a sprain. 20 minutes later the doctor calls and tells me that a radiologist got a hold of it and pointed out a moderate to severe spondylolysis (fracture of the pars articularis). Additionally, I have a very degenerated disc at L2 (how they got that from an x-ray and not a CT or MRI I don’t know).

I know the rehab protocols that I would get in PT, and will most likely not touch a squat or deadlift variant until at least 2-3 weeks from now, or until another x-ray or bone scan confirms things are healing appropriately. Starting today or tomorrow, now that my spasms are gone, I will start doing as many neutral based core exercises as I can, possibly some involved with flexion if my back feels stable enough.

Question #1: Anybody hear anything positive about strontium, increased vitamin D3 (I take 6-8000 IU’s a day), increased calcium, increased fish oil, cissus, or anything else? I would love for this to heal as efficiently as possible and in a timely manner.

Question #2: I love olympic weightlifting and squatting in general. However, am I fucked? I’m in my early 20’s, and don’t want to induce severe injuries that will fuck me up for the rest of my life. Has anyone been put in a similar situation? I know this is common with gymnasts and weightlifters, but I doubt they are routinely cleaning and snatching. Seems like the spinal loading I will impose on myself will be much greater than their repeated extension.

2

You’re not fucked. It’s certainly not an ideal situation though and you may have to alter your lifting habits some in the future. I wouldn’t do any core work at all for at least 2-4 weeks (not even exercises without flexion like bridges). If there is a fracture there, unfortunately, it will never heal. You should be able to lift again anyway though, so it’s not as scary as it may sound. Even with a spondylolisthesis, shear forces are much more dangerous for your spine than compressive forces. I would imagine you will be able to squat again (certainly front squat) but check in with a smart PT or doc familiar with Oly Lifting patients before getting into it again. Start with the bar and work your way up in 5-10 lbs. increments. Don’t even think about going back to working weights until you have worked your way up to it through a slow progression. Expect to deal with some pain over the next 6 months or so and intermittently in the future (some lucky folks are a-symptomatic and don’t experience pain but better to be prepared). Stuart McGill is a great source of information for dealing with spine issues and working around them.